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Contact Information

PRISMA WISCONSIN LLC
13500 WATERTOWN PLANK RD STE 102
ELM GROVE, WI53122-2222
 Phone: 206-785-1015
 Fax: 206-785-1023
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Psychiatric/Mental Health, Adult

364SP0809X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for PRISMA WISCONSIN LLC · (Female)

NPI Number 1497519979
Status Active
Credentials
Entity Individual
Enumeration date 02/06/2024
Last updated 02/06/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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